‘Medicare for All’: Should the U.S. Adopt a Single-Payer Healthcare System? (H.R. 1384)
Do you support or oppose this bill?
What is H.R. 1384?
(Updated June 28, 2020)
This bill — the Medicare for All Act — would provide individuals residing in the U.S. with healthcare for all “medically necessary care” under a single-payer healthcare system. Medically necessary care would include primary care, prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care. Patients would be able to choose to receive care from any qualified institution, agency, or individual.
Only public or nonprofit institutions would be allowed to participate. Health insurers would be prohibited from selling insurance that duplicates the benefits provided under this bill, but could sell benefits that aren’t medically necessary such as cosmetic surgery. Healthcare providers would be paid for their operating expenses (like salaries and medical devices) by the government each fiscal quarter based on established compensation guidelines. Costs would be reviewed by a regional healthcare director each quarter.
People currently enrolled in federal healthcare programs through the Dept. of Veterans Affairs (VA) or the Indian Health Service would maintain their current medical benefits and services.
Argument in favor
A single-payer healthcare system is the best way to ensure that all Americans have access to the healthcare they need without having to worry about paying for health insurance. It would be more efficient than the status quo at controlling costs and produce better outcomes while bringing the U.S. in line with other developed nations with single-payer systems.
Argument opposed
A single-payer healthcare system would concentrate too much power in the federal government, creating inefficiencies in the healthcare market. It would reduce physicians’ pay and consequently the quality of care they provide, and lead to long wait lists for patients to see their doctor — all while imposing a massive tax increase on middle-class Americans.
Impact
American healthcare consumers and taxpayers; healthcare providers; insurers; and the federal government.
Cost of H.R. 1384
A CBO cost estimate is unavailable.
Additional Info
In-Depth: Rep. Pramila Jayapal (D-WA) introduced this bill to expand Medicare so that every person living in the U.S. “has guaranteed access to healthcare with comprehensive benefits” and offered the following statement upon its introduction:
“Today in America, 30 million people are uninsured. 40 million are underinsured. We have the most expensive healthcare system in the world and yet our outcomes are the worst of all industrialized countries. I and the more than 100 co-sponsors of this bill refuse to allow this to continue. It’s time to put people’s health over profit. Our bill will cover everyone. Not just those who are fortunate enough to have employer-sponsored insurance. Not just children. Not just seniors. Not just those who are healthy. Everyone. Because healthcare is a human right… It is time to ensure that healthcare is a right and not a privilege, guaranteed to every single person in our country. It is time for Medicare for All.”
Jayapal’s bill doesn’t include any tax increases to pay for the increased cost, although she has indicated that she will release a list of potential tax increases (possibly including a “wealth tax” or repealing tax cuts) separately after the bill’s introduction on February 27, 2019. However, no such list has been publicly released or added to her website’s Medicare for All Act resources page as of April 29, 2019.
Detractors argue that a ‘Medicare for All’ single-payer healthcare system would be extraordinarily costly and would have a detrimental impact on the economy. An analysis by the Mercatus Center, a free market-oriented think tank, found that a similar Medicare for All bill sponsored by Sen. Bernie Sanders (I-VT) would cost at least $32.6 trillion over 10 years — or roughly $3.26 trillion per year — a funding gap so large that doubling personal and corporate income taxes couldn’t erase it. The study’s authors say those “estimates are conservative because they assume the legislation achieves its sponsors’ goals of dramatically reducing payments to health providers, in addition to substantially reducing drug prices and administrative costs.” They add:
“A doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan… M4A would markedly increase the demand for healthcare services while simultaneously cutting payments to providers by more than 40 percent relative to private insurance rates, reducing payments to levels that are lower on average than providers’ current costs of providing care. It cannot be known how much providers will react to these losses by reducing the availability of existing health services, the quality of such services, or both.”
This legislation has the support of 108 cosponsors in the House, all of whom are Democrats.
- 70% opposed a healthcare system that’d lead to delays in people getting some medical tests and treatments.
- 60% opposed a plan that’d threaten the current Medicare system.
- 60% opposed a plan that’d require most Americans to pay more in taxes.
- 58% opposed eliminating private health insurance companies.
Media:
Countable (Context)
Mercatus Center (Context)
Mercatus Center (Additional Context)
Summary by Eric Revell
(Photo Credit: mollytkadams via Flickr / Creative Commons)
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